Provider Demographics
NPI:1043743917
Name:GRUBB, JAMIE LAYNE (DOCTOR OF PHARMACY)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LAYNE
Last Name:GRUBB
Suffix:
Gender:F
Credentials:DOCTOR OF PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:238 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-9609
Mailing Address - Country:US
Mailing Address - Phone:859-893-4935
Mailing Address - Fax:606-287-3646
Practice Address - Street 1:551 MAIN ST N
Practice Address - Street 2:
Practice Address - City:MC KEE
Practice Address - State:KY
Practice Address - Zip Code:40447-9082
Practice Address - Country:US
Practice Address - Phone:606-287-7187
Practice Address - Fax:606-287-3646
Is Sole Proprietor?:No
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist